FESSH prep Wrist trauma Scaphoid imaging
Scaphoid fracture diagnosis and imaging
Regarding the clinical assessment and imaging of suspected acute scaphoid fractures in adults:
1.Anatomical snuffbox tenderness is sensitive but non-specific for scaphoid fracture in isolation; combining it with scaphoid tubercle tenderness and longitudinal thumb compression substantially improves predictive value.
2.CT is the gold-standard imaging modality for detecting radiographically occult scaphoid fractures.
3.Among MRI, CT and bone scintigraphy, MRI offers the best balance of sensitivity and specificity for detecting radiographically occult scaphoid fracture.
4.Bone scintigraphy reliably detects scaphoid fractures within 24 hours of injury.
5.If initial radiographs are negative, wrist immobilisation should be discontinued pending advanced imaging.
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